Provider Demographics
NPI:1407236813
Name:LATROBE AREA HOSPITAL, INC.
Entity Type:Organization
Organization Name:LATROBE AREA HOSPITAL, INC.
Other - Org Name:LAH FAMILY MEDICINE BEHAVIORAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DISHONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-830-8500
Mailing Address - Street 1:1 MELLON WAY
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-1197
Mailing Address - Country:US
Mailing Address - Phone:724-537-1480
Mailing Address - Fax:724-539-6353
Practice Address - Street 1:1 MELLON WAY
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1197
Practice Address - Country:US
Practice Address - Phone:724-537-1480
Practice Address - Fax:724-539-6353
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXCELA HEALTH HOLDING COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100761052Medicaid
PA401949Medicare PIN